CMS Price Transparency Data
Neurobehavioral status check
Facility: Children's Hosp of Los Angeles
Billing Code: 96116 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 96116
- Insurance Median: $63
- Cash Discount Price: $93
- vs. Medicare Baseline: 0.29x Medicare
The contracted insurance negotiated median rate for a Neurobehavioral status check at Children's Hosp of Los Angeles is $63. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $93. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 0.29x the Medicare baseline. Located in 4650 Sunset Blvd, Ms 108, Los Angeles, CA.
Cash / Self-Pay
$93
Average discount available for prompt cash payment at this facility.
Insurance Median
$63
Median negotiated contract rate across all mapped commercial carriers.
Medicare Reference Rate
$220.6
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Medicare Reference Baseline: $220.6 (100%)
Cash / Self-Pay: $93 (42%)
Insurance Median: $63 (29%)
Cash: $93 (42% of Medicare)
Ins. Median: $63 (29% of Medicare)
Understanding this gauge: We use the federal Medicare rate of $220.6 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.
Out-of-Pocket Cost Estimator
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Molina | $14 - $93 | 6% |
| Inland Empire Health Plan | $14 - $93 | 6% |
| Medi-Cal | $14 - $45 | 6% |
| Shriners Hospital | $28 | 13% |
| Medicaid / KanCare | $28 - $93 | 13% |
| Beech Street | $37 | 17% |
| Non-Contract Payors | $37 | 17% |
| Incentive Health Network | $37 | 17% |
| Health Net | $39 - $116 | 18% |
| Emanate Health Medical Center Mmc | $42 | 19% |
| Cigna | $43 | 19% |
| Kaiser | $43 - $53 | 19% |
| Axminster Medical Group | $45 - $93 | 20% |
| St. John's Health Clinic | $45 - $93 | 20% |
| Facey Medical Group | $45 - $93 | 20% |
| Gemcare IPA | $46 | 21% |
| Pioneer Prov Ntwk | $46 | 21% |
| Citrus Valley Phys Grp | $46 - $60 | 21% |
| La Care | $46 - $93 | 21% |
| UnitedHealthcare | $46 - $93 | 21% |
| Altamed | $46 - $93 | 21% |
| Mercy Care | $46 | 21% |
| Sansum Clinic | $46 | 21% |
| Exceptional Care Medical Group | $46 - $93 | 21% |
| Accarent Health | $46 | 21% |
| Staywell Insurance | $46 | 21% |
| Managed Care Systems | $46 | 21% |
| Book Md | $48 | 22% |
| Aetna | $48 - $51 | 22% |
| Applecare Medical Group | $49 - $93 | 22% |
| Good Samaritan Medical Group | $49 | 22% |
| Blue Shield | $50 - $93 | 23% |
| Bella Vista Med Grp | $51 - $93 | 23% |
| Intl - Global Medical Management | $51 | 23% |
| Centinela Valley IPA | $51 - $93 | 23% |
| Intl - Quality Health Management | $51 - $93 | 23% |
| Intl - Global Excel Management | $51 - $186 | 23% |
| Culinary Health Fund | $51 - $93 | 23% |
| Choice Medical Group | $51 | 23% |
| Health Care La IPA | $51 - $93 | 23% |
| Community Care | $51 | 23% |
| National Healthcare Solutions | $51 | 23% |
| Premier Physicians Ntwk | $51 - $93 | 23% |
| Global Care Medical Group | $51 - $93 | 23% |
| Blue Cross Blue Shield | $54 - $93 | 24% |
| Seoul Medical Group | $55 | 25% |
| Access Medical Group | $55 | 25% |
| Delta Health Systems | $56 | 25% |
| Providence Health Network | $56 | 25% |
| Family Care Specialists | $56 - $93 | 25% |
| Ventura County Health Plan | $56 | 25% |
| Allied Pacific IPA | $56 - $93 | 25% |
| Preferred IPA - Commercial | $56 | 25% |
| Valley Presbyterian Hospital | $56 - $93 | 25% |
| Alhambra Hospital Medical Center | $56 - $93 | 25% |
| Private Hlthcare System | $56 | 25% |
| Sanus Health | $56 | 25% |
| Heritage Provider Network | $56 - $93 | 25% |
| Emanate Health Medical Center Commercial | $56 | 25% |
| Los Angeles Medical Center IPA | $56 - $93 | 25% |
| Bright Medical Associates | $56 | 25% |
| Self-Pay | $56 | 25% |
| Sierra Health and Life Insurance Company | $58 | 26% |
| Lakewood Health Plan | $60 | 27% |
| Redlands Community Hospital | $60 | 27% |
| Seaside Health Plan | $60 - $93 | 27% |
| Serra Community Med Clinic - Commercial | $60 | 27% |
| Plotkin Health | $60 | 27% |
| Intl - Erv Travel Services | $60 - $65 | 27% |
| Cedar Sinai Med Grp | $60 | 27% |
| Marian Health Services | $60 | 27% |
| Intl - Concierge Healthcare Services | $60 | 27% |
| Intl - Aixin Life Insurance Co | $60 - $93 | 27% |
| Axis Services International | $60 | 27% |
| Prime Health Services | $60 | 27% |
| Star Healthcare Network Commercial | $60 | 27% |
| Intl - Msh China Enterprise Services | $60 | 27% |
| Calvo Selectcare | $60 | 27% |
| Embassy - Saudi Arabia | $60 | 27% |
| Beaver Medical Group | $65 | 29% |
| Memorialcare Med Foundation | $65 | 29% |
| Korean American Med Grp | $65 | 29% |
| Multiplan | $65 | 29% |
| Angeles IPA | $65 - $93 | 29% |
| Primecare Medical Network | $65 | 29% |
| St Francis Medical Center | $67 - $93 | 30% |
| Associated Hispanic Physicians IPA | $70 - $93 | 32% |
| Embassy - Kuwait | $70 | 32% |
| Prospect Medical Group | $70 | 32% |
| Interlink Health Services | $70 | 32% |
| Hispanic Physician IPA | $70 - $93 | 32% |
| Choc Health Alliance | $70 | 32% |
| Self-Pay International | $74 | 34% |
| Embassy - All Others | $74 | 34% |
| Caloptima | $79 - $93 | 36% |
| El Proyecto Del Barrio | $82 - $93 | 37% |
| Watts Healthcare Mmc | $82 - $93 | 37% |
| Community Family Care IPA | $84 - $93 | 38% |
| Hollywood Presbyterian Medical Center | $84 - $93 | 38% |
| Serendib Healthways Mmc | $91 - $93 | 41% |
| Medicare (plans) | $92 - $273 | 42% |
| Primary Care and Pediatric IPA | $93 | 42% |
| Karing Physicians Medical Group | $93 | 42% |
| Gold Coast Health Plan | $93 | 42% |
| Care 1St | $93 | 42% |
| Southern Atlantic Medical Group Mmc | $93 - $149 | 42% |
| Serra Community Med Clinic | $93 | 42% |
| Cencal Health | $93 | 42% |
| Souther California Hosp System - Mmc | $93 | 42% |
| White Memorial Medical Center | $93 | 42% |
| Kern Family Health Plan | $93 | 42% |
| Family Health Alliance Med Grp | $93 | 42% |
| Asian Community Medical Group | $93 | 42% |
| Cal Care IPA | $93 | 42% |
| Regent Medical Group | $93 | 42% |
| Pacific Alliance Medical Center | $93 | 42% |
| Adventist Health Physicians | $93 - $500 | 42% |
| Preferred IPA | $93 | 42% |
| Point Comfort Underwriters | $93 | 42% |
| Imperial Health Holdings Medical Group | $93 | 42% |
| Mabuhay Medical Group | $93 | 42% |
| San Judas Med Grp | $93 | 42% |
| Accountable Health | $93 | 42% |
| Community Care IPA Mmc | $93 | 42% |
| Superior Choice Medical Group | $93 | 42% |
| Dignity Health | $93 | 42% |
| Crown City Medical Group | $93 | 42% |
| Southland San Gabriel Valley Medical Group | $93 | 42% |
| Avalon IPA | $93 | 42% |
| Healthy New Life Medical Corp | $93 | 42% |
| Beverly Hospital | $93 | 42% |
| Noble Community Medical Associates | $93 | 42% |
| California Pacific Physicians Medical Group | $93 | 42% |
| Employee Health Systems Med Grp | $93 | 42% |
| Champus | $269 | 122% |